Ultrasonography: pancreas

Buy now to access the full article, existing subscribers login

Sections available in full article Introduction ,  Equipment ,  Patient preparation ,  Technique ,  Normal anatomy ,  Abnormalities ,  Sources, Publications, Vetstream contributor(s),
Introduction ,  Equipment ,  Patient preparation ,  Technique ,  Normal anatomy ,  Abnormalities ,  Sources,
Contributors Mr Andrew Holloway BVSc CertSAM DVDI DipECVDI MRCVS European Specialist in Veterinary Diagnostic Imaging
Mr Fraser J McConnell BVM&S CertSAM DVR DipECVDI MRCVS

Introduction

Uses

  • Investigation of:
    • Clinical symptoms suspicious of pancreatitis  Pancreatitis   (anorexia, lethargy, dehydration, hypothermia and signs of multiorgan disease (liver, kidney, pleural effusion)).
    • Vomiting  Vomiting  .
    • Abdominal pain.
    • Cranial abdominal mass.
    • Abdominal trauma.
    • Jaundice.
    • Ascites.
    • Fever.
    • Hypoglycemia  Hypoglycemia  /collapse.

Advantages

  • Low cost.
  • Non-invasive.
  • Short time requirement if experienced.
  • Examination possible without sedation.
  • No known biological risk.
  • Allows ultrasound guided fine needle aspiration or biopsy.
  • Allows evaluation of other organs for related problems, eg hepatic, intestinal and renal disease.
  • Time requirement will reduce with operator experience.

Disadvantages

  • Investigation is dependent on operator skill and suitability of ultrasonographic equipment.
  • Examination is poorly reproducible and remote interpretation difficult.
  • May require patient's coat to be clipped.
  • Normal sonographic appearance does not exclude disease.
  • Failure to identify pancreas does not exclude disease.
  • Gives no information on pancreatic function (especially exocrine pancreatic insufficiency  Exocrine pancreatic insufficiency  ).
  • Abnormal sonographic appearance does not always indicate significant disease.
  • Similar sonographic appearance with different diseases (ie no difference between acute pancreatic necrosis, chronic interstitial pancreatitis, suppurative pancreatitis). Differentiation of pancreatitis from neoplasia  Pancreas: neoplasia   may not be possible.

Potential problems

  • Poor transducer-skin contact:
    • Inadequate clipping.
    • Insufficient coupling medium.
  • Inadequate patient restraint.
  • Operator inexperience.
  • Excess intestinal gas.
  • Inadequate equipment. The superficial location of the pancreas in cats and may result in poor visualization of superficial structures due to near field artifacts.

Alternatives

  • Exploratory surgery for confirmation of extrahepatic bile duct obstruction  Bile duct: disease  .
  • CT  Computed tomography (CT)   (sensitivity for identifying pancreatitis is reported to be similar to that of ultrasound). Contrast enhanced CT may be more useful than ultrasound in differentiating necrotic/non-vascularized pancreatic tissue.

Sources

Publications

Refereed papers


  • Recent references from  PubMed .
  • Coleman M C & Robson M (2005)  Pancreatic Masses Following Pancreatitis: Pancreatic Pseudocysts, Necrosis, and Abscesses. Compend Contin Educ Pract Vet 27 (2), 147-154.
  • Whittemore J C & Campbell V L (2005) Canine and Feline Pancreatitis. Compend Contin Educ Pract Vet 27 (10), 766-776.
  • Monteiro C B, O'Brien R T (2004) A retrospective study on the sonographic findings of abdominal carcinomatosis in 14 cats. Vet Radiol Ultrasound 45 (6), 559-564  PubMed .
  • Ferreri J A, Hardam E, Kimmel S E, Saunders M,Van Winkle T J, Drobatz K J, Washabau R J (2003) Clinical Differentiation of Acute Necrotizing from Chronic Nonsuppurative Pancreatitis in Cats: 63 Cases (1996-2001). J Am Vet Med Assoc 223 (4), 469-474  PubMed .
  • Saunders M H, VanWinkle T J, Drobatz K J, Kimmel S E, Washabau R J (2002) Ultrasonographic Findings in Cats with Clinical, Gross Pathologic, and Histologic Evidence of Acute Pancreatic Necrosis: 20 Cases (1994-2001). J Am Vet Med Assoc 221 (12), 1724-1730  PubMed .
  • Bennett P F, Hahn K A, Toal R L, Legendre A M (2001)  Ultrasonographic and Cytopathological Diagnosis of Exocrine Pancreatic Carcinoma in the Dog and Cat.  J Am Anim Hosp Assoc 37 (5), 466-473  PubMed .
  • Mansfield C S & Jones B R (2001)  Review of Feline Pancreatitis Part One: The Normal Feline Pancreas, The Pathophysiology, Classification, Prevalence and Aetiologies of Pancreatitis.   J Feline Med Surg 3 (3), 117-124  PubMed .
  • Mansfield C S & Jones B R (2001)  Review of Feline Pancreatitis Part Two: Clinical Signs, Diagnosis and Treatment. J Feline Med Surg 3 (3), 125-132  PubMed .
  • Steiner J M, Williams D A, MA (1997)   Feline Exocrine Pancreatic Disorders: Insufficiency, Neoplasia, and Uncommon Conditions.   Compend Contin Educ Pract Vet 19 (7), 836-849.
  • Leveille R,  Biller D S,  Shiroma J T (1996)  Sonographic evaluation of the common bile duct in cats. J Vet Intern Med 10 (5), 296-299  PubMed .
  • Elie M & Zerbe C A (1995)  Insulinoma in Dogs, Cats, and Ferrets. Compend Contin Educ Pract Vet 17 (1), 51-59.
  • Hawks D, Peterson M E, Hawkins K L, Rosebury W S (1992) Insulin-secreting pancreatic (islet cell) carcinoma in a cat. J Vet Intern Med 6 (3), 193-196  PubMed .
  • O'Brien T D, Norton F, DVM, Turner T M, Johnson K H (1990)  Pancreatic endocrine tumor in a cat: Clinical, pathological, and immunohistochemical evaluation.   J Am Anim Hosp Assoc 26 (5), 453-457.

 

Sample content only, to unlock the full article login or buy now

Loading...